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International Journal of Surgery Case... Jun 2024Subglottic stenosis (SGS) appears to be a commonly encountered condition in the paediatric age group. Single stage cricoid split laryngoplasty with costochondral rib...
INTRODUCTION AND IMPORTANCE
Subglottic stenosis (SGS) appears to be a commonly encountered condition in the paediatric age group. Single stage cricoid split laryngoplasty with costochondral rib grafting in paediatric patients is a unique, innovative, and advanced operation in nature. Morbidity and mortality rates can be minimized with early diagnosis and prompt treatment.
PRESENTATION OF CASE
Presenting the case of a 13-month-old child diagnosed with Grade II SGS who was managed for cricoid split laryngoplasty with a costochondral rib graft. It was a unique strategy for providing infants and neonates with symptomatic SGS with a safe and efficient substitute for long-term tracheostomy. When healing was completed, the patient regained the function of their airway. The approach was successful, and preventable to long-term tracheostomy.
DISCUSSION
Performing this procedure early in children has shown higher rates of success and it is safe and effective. Further extensive research and studies need to be conducted in this domain, and every patient's status should be reviewed time and again to tend to their specific needs, and the choice of procedure should be made optimally based on clinical evaluations.
CONCLUSION
Successful management of a 13-month-old child with Grade II subglottic stenosis through cricoid split laryngoplasty with costochondral rib grafting is a challenging and novel approach to treating single-stage SGS.
PubMed: 38943940
DOI: 10.1016/j.ijscr.2024.109952 -
International Journal of Surgery Case... Jun 2024A right side diaphragmatic injury was linked to serious trauma to the abdomen, pelvis, and chest. The most significant type of injury was blunt abdominal trauma...
INTRODUCTION
A right side diaphragmatic injury was linked to serious trauma to the abdomen, pelvis, and chest. The most significant type of injury was blunt abdominal trauma sustained in a car collision. The left side was more likely than the right to experience herniation. The stomach and colon were the most often herniated abdominal viscera. In the same location as the diaphragm rupture, there were rib fractures, hemothorax, and liver damage. Delayed diaphragmatic rupture with diaphragmatic hernia is rare and has a mysterious nature.
CASE PRESENTATION
A 68 years old female patient who has repeated history of shortness of breath, for which she treated as lung infection presented with sudden exacerbation of shortness of breath, she witnessed history of blunt trauma 20 years back and up on investigation bowel herniation to the chest cavity diagnosed. Posteriolateral thoracotomy done, the herniated bowel reduced and the diaphragmatic defect repaired. The patient significantly improved and discharged from the hospital smoothly on 4th postoperative day.
DISCUSSION
Careful recording of past history and physical examination are the best approaches in diagnosing delayed presentation of traumatic diaphragmatic rupture. CT scan with reconstruction of the diaphragm is helpful in both diagnosis and differential diagnosis. Surgical therapy after diagnosis is the best treatment.
CONCLUSION
Delayed right side diaphragmatic hernia is a rare entity resulting in grave consequences, In a patient with history of trauma there should be a high index of suspension and patients should undergo imaging and surgical management is the best treatment.
PubMed: 38943935
DOI: 10.1016/j.ijscr.2024.109973 -
International Journal of Surgery Case... Jun 2024The surgical removal of unexploded mortar shells is rarely documented in the literature. Since most cases occur within war or conflict regions, reporting such instances...
INTRODUCTION AND SIGNIFICANCE
The surgical removal of unexploded mortar shells is rarely documented in the literature. Since most cases occur within war or conflict regions, reporting such instances is vital for optimizing and enhancing surgical practices, particularly in low-resource settings.
CASE PRESENTATION
We report the case of a 35-year-old man who sustained an injury from a 60 mm unexploded mortar shell, penetrating the patient's right posterior chest in the right paravertebral region of the 4th thoracic vertebra, causing intrathoracic injuries, multiple rib fractures, and a right pneumothorax. The patient was immediately resuscitated and transferred to the operating room. The projectile was removed without direct contact with metal instruments. A right chest tube was then inserted and the injured area was repaired, resulting in an uneventful postoperative recovery.
CLINICAL DISCUSSION
Unexploded mortar shell injuries are infrequently documented in the literature. These injuries are seen within war and conflict regions, that have limited accessibility or availability of experienced explosive ordnance disposal (EOD) teams, transporting personnel, and equipped and separated operating theaters.
CONCLUSION
Unexploded ordnance and munitions represent an underrecognized and underreported health risk to patients, healthcare providers, and healthcare facilities. These injuries are commonly encountered within regions that lack experienced transport and EOD staff. The need for the establishment of such experienced teams along with providing adequate training for healthcare providers is necessary.
PubMed: 38943933
DOI: 10.1016/j.ijscr.2024.109967 -
Journal of Cardiothoracic Surgery Jun 2024Late hemothorax is a rare complication of blunt chest trauma. The longest reported time interval between the traumatic event and the development of hemothorax is 44 days.
BACKGROUND
Late hemothorax is a rare complication of blunt chest trauma. The longest reported time interval between the traumatic event and the development of hemothorax is 44 days.
CASE PRESENTATION
An elderly patient with right-sided rib fractures from chest trauma, managed initially with closed thoracostomy, presented with a delayed hemothorax that occurred 60 days after initial management, necessitating conservative and then surgical intervention due to the patient's frail condition and associated complications.
CONCLUSIONS
This case emphasizes the clinical challenge and significance of delayed hemothorax in chest trauma, highlighting the need for vigilance and potential surgical correction in complex presentations, especially in the elderly.
Topics: Humans; Hemothorax; Wounds, Nonpenetrating; Thoracic Injuries; Rib Fractures; Male; Thoracostomy; Time Factors; Aged, 80 and over; Tomography, X-Ray Computed; Aged
PubMed: 38937751
DOI: 10.1186/s13019-024-02914-5 -
Facial Plastic Surgery Clinics of North... Aug 2024The authors present the contemporary landscape for males seeking Asian blepharoplasty and Asian rhinoplasty, with special emphasis on the unique anatomical and aesthetic... (Review)
Review
The authors present the contemporary landscape for males seeking Asian blepharoplasty and Asian rhinoplasty, with special emphasis on the unique anatomical and aesthetic considerations for this patient population. The authors highlight the latest techniques used to achieve superlative results.
Topics: Humans; Rhinoplasty; Blepharoplasty; Male; Asian People; Esthetics
PubMed: 38936994
DOI: 10.1016/j.fsc.2024.03.005 -
World Neurosurgery Jun 2024To explore the clinical effect of percutaneous kyphoplasty via Process-Rib-Pedicle approach for upper and middle thoracic osteoporosis fracture with Pedicle Stenosis.
OBJECTIVE
To explore the clinical effect of percutaneous kyphoplasty via Process-Rib-Pedicle approach for upper and middle thoracic osteoporosis fracture with Pedicle Stenosis.
METHODS
This study is a retrospective observational study. In this study, we retrospectively analyzed the data of 62 patients with upper thoracic vertebral bone loss compression fracture (OVCF) treated via the Process-Rib-Pedicle pathway PKP at the First Affiliated Hospital of Soochow University from January 2020 to December 2022. The patients were divided into group A(Unilateral PKP, 38 cases) and group B(Bilateral PKP, 24 cases) . The aspects of surgical safety, clinical efficacy and radio-logical outcome were investigated.
RESULTS
All 62 patients successfully completed the surgery without any spinal cord, nerve, or vascular injury, and there were no complications such as infection and vascular embolism. The differences in VAS scores(P<0.05), ODI functional index(P<0.05), and Cobb angle(P<0.05) were significant when comparing preoperative and postoperative periods, and the differences were not significant when comparing the postoperative periods (P>0.05); There were no statistically significant differences in days of hospital stay(P=0.653), and the rate of bone cement leakage (P=0.537 )between the two groups.
CONCLUSION
For upper middle osteoporotic thoracic vertebral fractures with pedicle stenosis, puncture via the Process-Rib-Pedicle path is a safe and reliable puncture route, and more than 2.5 ml of cement can achieve good clinical outcomes, regardless of bilateral or unilateral PKP.
PubMed: 38936613
DOI: 10.1016/j.wneu.2024.06.123 -
Micromachines May 2024A novel microchannel heat sink (TFMCHS) with trapezoidal ribs and fan grooves was proposed, and the microchannel was manufactured using selective laser melting...
A novel microchannel heat sink (TFMCHS) with trapezoidal ribs and fan grooves was proposed, and the microchannel was manufactured using selective laser melting technology. Firstly, the temperature and pressure drop at different power levels were measured through experiments and then combined with numerical simulation to explore the complex flow characteristics within TFMCHSs and evaluate the comprehensive performance of microchannel heat sinks based on the thermal enhancement coefficient. The results show that, compared with rectangular microchannel heat sinks (RMCHSs), the average and maximum temperatures of TFMCHSs are significantly reduced, and the temperature distribution is more uniform. This is mainly caused by the periodic interruption and redevelopment of the velocity boundary layer and thermal boundary layer caused by ribs and grooves. And as the heating power increases, the TFMCHS has better heat dissipation performance. When P=33 W and the inlet flow rate is 32.5 mL/min, the thermal enhancement factor reaches 1.26.
PubMed: 38930683
DOI: 10.3390/mi15060713 -
Materials (Basel, Switzerland) Jun 2024Orthotropic steel decks (OSDs) are commonly used in the construction of bridges due to their load-bearing capabilities. However, they are prone to fatigue damage over...
Orthotropic steel decks (OSDs) are commonly used in the construction of bridges due to their load-bearing capabilities. However, they are prone to fatigue damage over time due to the cyclic loads from vehicles. Therefore, the early structural health monitoring of fatigue damage in OSDs is crucial for ensuring bridge safety. Moreover, Lamb waves, as elastic waves propagating in OSD plate-like structures, are characterized by their long propagation distances and minimal attenuation. This paper introduces a method of emitting high-energy ultrasonic waves onto the OSD surface to capture the nonlinear Lamb waves formed, thereby calculating the nonlinear parameters. These parameters are then correlated with the fatigue damage endured, forming a damage index (DI) for monitoring the fatigue life of OSDs. Experimental results indicate that as fatigue damage increases, the nonlinear parameters exhibit a significant initial increase followed by a decrease. The behavior is distinct from the characteristic parameters of linear ultrasound (velocity and energy), which also exhibit changes but to a relatively smaller extent. The proposed DI and fatigue life based on nonlinear parameters can be fitted with a Gaussian curve, with the R-squared value of the fitting curve being close to 1. Additionally, this paper discusses the influence of rib welds within the OSDs on the DI, whereby as fatigue damage increases, it enlarges the value of the nonlinear parameters without altering their trend. The proposed method provides a more effective approach for monitoring early fatigue damage in OSDs.
PubMed: 38930164
DOI: 10.3390/ma17122792 -
Posterior-Only T11 Vertebral Column Resection for Pediatric Congenital Kyphosis Surgical Correction.Medicina (Kaunas, Lithuania) May 2024: Congenital kyphosis is a spinal deformity that arises from the inadequate anterior development or segmentation of the vertebrae in the sagittal plane during the...
: Congenital kyphosis is a spinal deformity that arises from the inadequate anterior development or segmentation of the vertebrae in the sagittal plane during the initial embryonic stage. Consequently, this condition triggers atypical spinal growth, leading to the manifestation of deformity. Concurrently, other congenital abnormalities like renal or cardiac defects within the gastrointestinal tract may co-occur with spinal deformities due to their shared formation timeline. In light of the specific characteristics of the deformity, the age range of the patient, deformity sizes, and neurological conditions, surgical intervention emerges as the optimal course of action for such cases. The selection of the appropriate surgical approach is contingent upon the specific characteristics of the anomaly. : This investigation illustrates the utilization of a surgical posterior-only strategy for correcting pediatric congenital kyphoscoliosis through the implementation of a vertebral column resection method along with spine reconstruction employing a mesh cage. The individual in question, a 16-year-old female, exhibited symptoms such as a progressive rib hump, shoulder asymmetry, and back discomfort. Non-invasive interventions like bracing proved ineffective, leading to the progression of the spinal curvature. After the surgical procedure, diagnostic imaging displayed a marked enhancement across all three spatial dimensions. After a postoperative physical assessment, it was noted that the patient experienced significant enhancements in shoulder alignment and rib hump prominence, with no discernible neurological or other adverse effects. : Surgical intervention is considered the optimal approach for addressing such congenital anomalies. Typically, timely surgical intervention leads to favorable results and has the potential to halt the advancement of deformity and curvature enlargement.
Topics: Humans; Kyphosis; Female; Adolescent; Thoracic Vertebrae; Treatment Outcome; Scoliosis
PubMed: 38929517
DOI: 10.3390/medicina60060897 -
Animals : An Open Access Journal From... Jun 2024Stearoyl-CoA desaturase-1 () is a key enzyme in the biosynthesis of monounsaturated fatty acids and is considered a candidate gene for improving milk and meat quality...
Stearoyl-CoA desaturase-1 () is a key enzyme in the biosynthesis of monounsaturated fatty acids and is considered a candidate gene for improving milk and meat quality traits. Sanger sequencing was employed to investigate the genetic polymorphism of the fifth exon and intron of bovine , revealing four SNPs, g.21272246 A>G, g.21272306 T>C, g.21272422 C>T, and g.21272529 A>G. Further variance analysis and multiple comparisons were conducted to examine the relationship between variation sites and economic traits in Chinese Simmental cattle, as well as milk production traits in Holstein cows. The findings revealed these four loci exhibited significant associations with carcass traits (carcass weight, carcass length, backfat thickness, and waist meat thickness), meat quality (pH value, rib eye area, and marbling score), adipogenic traits (fat score and carcass fat coverage rate), and fatty acid composition (linoleic acid and α-linolenic acid). Furthermore, these loci were additionally found to be significantly associated with average milk yield and milk fat content in cows. In addition, a haplotype analysis of combinations of SNPs showed that H2H3 has a significant association with adipogenic traits and H2H2 was associated with higher levels of linoleic acid and α-linolenic acid than the other combinations. These results suggest that the four SNPs are expected to be prospective genetic markers for the above economic traits. In addition, the function of SNPs in exon 5 of on gene expression and protein structure needs to be explored in the future.
PubMed: 38929378
DOI: 10.3390/ani14121759